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Annular pancreas producing duodenal obstruction: A case report  [PDF]
Abdesslam Bouassria, Hicham Elbouhaddouti, Ouadii Mouaqit, El Bachir Benjelloun, Abdelmalek Ousadden, Khalid Mazaz, Khalid Ait Taleb
Open Journal of Gastroenterology (OJGas) , 2013, DOI: 10.4236/ojgas.2013.33032
Abstract:

Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the duodenum. This malformation is usually asymptomatic in adults, but can manifests as pancreatitis, duodenal stenosis, or duodenal or gastric ulceration. We report the case of a young patient of 18 years old hospitalized for epigastric pain and vomiting, in whom radiological investigations showed an annular pancreas. At operation, a complete obstruction of the duodenum between its first and second parts was found, caused by an annular pancreas. No other congenital anomaly of the intra abdominal organs was noted. A gastroenterostomy was performed. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.

MULTIPLE ASSOCIATED ANOMALIES IN PATIENTS OF DUODENAL ATRESIA: A CASE SERIES  [PDF]
Bilal Mirza,Afzal Sheikh
Journal of Neonatal Surgery , 2012,
Abstract: Duodenal atresia has been reported in association with various malformations and syndromes common being Down syndrome, malrotation, and annular pancreas. Its association with multiple anomalies is rare and scarcely reported in literature. Herein 3 cases of duodenal atresia associated with multiple congenital anomalies are being reported.
Annular Pancreas in Children: A Decade of Experience  [cached]
Murat Yigiter,Abdullah Yildiz,Binali Firinci,Onur Yalcin
Eurasian Journal of Medicine , 2010,
Abstract: Objective: Annular pancreas is an uncommon cause of duodenal obstruction in children. In this study, the clinical, radiological, and prognostic findings related to this disorder over a 12-year review period were analyzed.Materials and Methods: A retrospective review of 22 patients with annular pancreas who were treated with surgical repair between April 1998 and February 2010 was performed at two different pediatric surgical units. Presenting symptoms, associated anomalies, radiological findings, the type of surgery performed, postoperative outcomes, and complications were analyzed.Results: Twenty-two patients were identified. Thirteen of the 22 patients (59.1%) were born prematurely, 11 patients (50%) had low birth weight, 2 patients (9.1%) had very low birth weight and 1 patient (4.5%) had extremely low birth weight. The mean birth weight was 2285.23±675.12 g. (970-3300). All patients presented with vomiting, which was bilious in nine (40.9%). Nine patients (40.9%) had chromosomal anomalies. Corrective surgery consisted of duodenoduodenostomy in 9 patients (40.9 %), duodenojejunostomy in 9 patients (40.9%), and gastrojejunostomy in 4 patients (18.1%). Fourteen of the 22 patients have survived (63.6%). The causes of death were combinations of sepsis, pneumonia, brain hemorrhage, and cardiac anomaly. Conclusion: Infants with annular pancreas associated with duodenal obstruction were often born prematurely and/or had low birth weights; many had cardiovascular anomalies. Annular pancreas associated with duodenal obstruction correlated strongly with the trisomy 21 karyotype among the chromosomal anomalies, as did duodenal atresia. The oral feeding tolerance time was nearly the same for all patients regardless of the surgical procedure used.
A Classic Case of Annular Pancreas and its Clinical Implications
Nayak B,Satheesha; Mun Yooi,Ooi;
International Journal of Morphology , 2011, DOI: 10.4067/S0717-95022011000200043
Abstract: annular pancreas is a rare developmental anomaly where the head of the pancreas surrounds the second part of the duodenum like a ring. this may cause the duodenal constriction, obstruction, peptic ulcers and other complications. we saw a classic case of annular pancreas. the head of pancreas surrounded the second part of duodenum completely. however there was no narrowing of the duodenum. the case may be of importance for gastroenterologists, surgeons and radiologists.
Gallbladder perforation associated with carcinoma of the duodenal papilla: a case report
Akihiro Hosaka, Mikiko Nagayoshi, Katsuyoshi Sugizaki, Yukiyoshi Masaki
World Journal of Surgical Oncology , 2010, DOI: 10.1186/1477-7819-8-41
Abstract: A 56-year-old man with carcinoma of the ampulla of Vater presented with spontaneous gallbladder perforation and localized bile peritonitis. He complained of right upper abdominal pain, and laparotomy revealed perforation of the gallbladder with no gallstones. Postoperative upper gastrointestinal endoscopy demonstrated a slightly enlarged duodenal papilla, and biopsy revealed adenocarcinoma of the ampulla. Pylorus-preserving pancreaticoduodenectomy was performed subsequently.Ampullary carcinoma can be associated with gallbladder perforation and present with acute manifestations. Immediate surgical treatment is required for this condition.Gallbladder perforation (GBP) is a rare but life-threatening condition, which usually requires immediate surgical intervention. Most cases are complicated by acute cholecystitis associated with cholelithiasis [1], although acute acalculous cholecystitis or intramural vessel thrombosis can sometimes lead to GBP [2,3].A tumor of the ampulla of Vater causes gradually progressive symptoms such as jaundice or weight loss, and rarely presents with acute manifestations [4-6]. In this report, we describe a case of ampullary carcinoma presenting with acute development of GBP and bile peritonitis, and discuss the clinical features of the disease.A 56-year-old man was referred to our hospital with right upper abdominal pain, which had worsened over the previous two days. He had been free of symptoms previously. He had a history of moderate smoking and alcohol consumption, and no appreciable medical or family history. On admission, his body temperature was 37.4°C. Blood examination showed a white blood cell count of 8900/mm3, C-reactive protein level of 0.08 mg/dl, total bilirubin level of 0.6 mg/dl, aspartate aminotransferase level of 57 IU/l, and alanine aminotransferase level of 67 IU/l. Computed tomography (CT) and echography demonstrated distention of the gallbladder and thickening of its wall and dilatation of the common bile duct, but no
Annular pancreas in adults (2 case reports).  [cached]
Machado N,Rajan N,Rao B
Journal of Postgraduate Medicine , 1991,
Abstract: Two cases of annular pancreas in adults are being reported. In the first case, a middle aged lady presented with duodenal obstruction and gastric ulcer. Anterior H. S. V. with posterior truncal vagotomy and isoperistaltic duodeno-jejunostomy relieved her symptoms. In the second case, a young girl presented with duodenal obstruction, severe wasting and gross dehydration. She had an uneventful recovery following a duodeno-jejunostomy.
Duodenal Carcinoma from a Duodenal Diverticulum Mimicking Pancreatic Carcinoma
Furukawa,Masashi,Izumi,Sadanobu,Tsukuda,Kazunori,Tokumo,Masaki
Acta Medica Okayama , 2012,
Abstract: An 81-year-old man was found to have a pancreatic head tumor on abdominal computed tomography (CT) performed during a follow-up visit for sigmoid colon cancer. The tumor had a diameter of 35mm on the CT scan and was diagnosed as pancreatic head carcinoma T3N0M0. The patient was treated with pylorus-preserving pancreaticoduodenectomy. Histopathological examination showed that the tumor had grown within a hollow structure, was contiguous with a duodenal diverticulum, and had partially invaded the pancreas. Immunohistochemistry results were as follows:CK7 negative, CK20 positive, CD10 negative, CDX2 positive, MUC1 negative, MUC2 positive, MUC5AC negative, and MUC6 negative. The tumor was diagnosed as duodenal carcinoma from the duodenal diverticulum. Preoperative imaging showed that the tumor was located in the head of the pancreas and was compressing the common bile duct, thus making it appear like pancreatic cancer. To the best of our knowledge, this is the second report of a case of duodenal carcinoma from a duodenal diverticulum mimicking pancreatic carcinoma.
A rare cause of proximal intestinal obstruction in adults - annular pancreas: A case report
B Mahdi, S Selim, T Hassen, MM Mongi, CM Fadhel, C Fathi, S Sadok
Pan African Medical Journal , 2011,
Abstract: Annular pancreas is a rare congenital anomaly characterized by the presence of ectopic pancreatic tissue surrounding the descending part of the duodenum. It is one of the few congenital anomalies of the gastrointestinal tract which can produce symptoms late in life. In adults, the factors initiating symptoms are recurrent pancreatitis, duodenal stenosis at the site of the annulus, or duodenal or gastric ulceration. We report a new case involving a 24-year-old woman hospitalised for epigastric pain, nausea and vomiting. Radiological examination was consisted with an annular pancreas. At operation a complete obstruction of the second part of the duodenum was found, caused by an annular pancreas, no other congenital anomaly of the intra-abdominal organs was noted. A gastroenterostomy was performed.
Anaplastic carcinoma associated with a mucinous cystic neoplasm of the pancreas during pregnancy: Report of a case and a review of the literature  [cached]
Kenichi Hakamada, Takuya Miura, Akitoshi Kimura, Masaki Nara, Yoshikazu Toyoki, Shunij Narumi, Mutsuo Sasak
World Journal of Gastroenterology , 2008,
Abstract: Oncogenesis of anaplastic carcinoma of the pancreas is a subject of controversy, because it shows sarcomatous nature with extremely poor prognosis. We herein report an unusual case of anaplastic carcinoma occurring with a recurrent mucinous cystic neoplasm in a 38-year-old female. A 10-cm retroperitoneal cystic mass was pointed out in the first pregnancy and a probable diagnosis of mucinous cystic neoplasm was made in October 2000. She refused surgery first and delivered her baby uneventfully. During her second pregnancy in 2002, however, she presented hematemesis and underwent urgent distal pancreatectomy, splenectomy and partial resection of the gastric wall where the tumor perforated. A diagnosis of borderline-type mucinous cystic neoplasm with ovarian-like stroma was made. Nine months later, CT visualized a recurrent cystic tumor near the pancreatic stump, which was subsequently resected. Pathology revealed that the tumor was composed of two different components of borderline-type mucinous cystic neoplasm and anaplastic carcinoma. The latter was intensely positive for vimentin, CD68, p53 and focally for cytokeratin, suggesting both sarcomatous and carcinomatous differentiation. She survived four years after the second surgery without tumor recurrence. Although the origin of anaplastic carcinoma has not been determined yet, it should be remembered that anaplastic carcinoma can occur in association with mucinous cystic neoplasm of more benign histology.
Squamous Cell Carcinoma of the Pancreas  [PDF]
Pierlesky Elion Ossibi, Issam Yazough, Amal Bennani, KarimIbn Majdoub, Imane Toughrai, Said Ait Laalim, Abdelmalek Ousadden, Laila Chbani, Khalid Mazaz, Khalid Ait Taleb
Surgical Science (SS) , 2014, DOI: 10.4236/ss.2014.510075
Abstract: Exocrine pancreatic tumors are dominated by adenocarcinomas that have a poor prognosis. Squamous Cell Carcinoma of the pancreas is rare. We report a case of squamous cell carcinoma of the pancreas in a 75-year-old patient admitted to the emergency ward with acute cholangitis.
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